Delta Dental of California notified California dentists in its FYI newsletter that dentists should be prepared for a quality assessment review. CDA members are encouraged to review the on-site QA review checklist provided in the April 9 newsletter to ensure compliance. On-site reviews are part of Delta Dental’s quality assessment program for contracted dentists in California, mandated by the California Department of Managed Health Care.

Delta Premier Providers who are class members of the Delta Dental class action lawsuit have until June 14, 2019, to cash their settlement checks. The $65 million settlement is the result of legal action CDA filed against Delta on behalf of members. Most settlement checks sent to approximately 14,000 class members have been cashed, but the class action settlement administrator reports that more than 500 settlement checks have yet to be cashed.

Approximately 14,000 dentists are expected to receive payments by the end of October as part of CDA’s settlement agreement with Delta Dental. The agreement, which was approved by the court in May and followed by a 60-day appeal period, provides $65 million to Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.” Dentists who did not have their fees reduced improperly by the inflationary adjustment percentage will not receive payments.

A class action settlement administrator has mailed allocation notices to approximately 14,000 Premier providers eligible for payments under CDA’s settlement agreement with Delta Dental. Although eligible dentists do not need to file a claim in order to receive their portion of the $65 million settlement, they should read the notice carefully and supply any requested changes of address.

Dentists eligible for payments under CDA’s settlement agreement with Delta Dental should expect to receive allocation notices within a few weeks. The class action settlement administrator plans to mail letters to approximately 14,000 Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.”

CDA Practice Support is hearing from members who have questions about the Delta Dental settlement, which CDA secured final court approval of in late April. Provided here are members’ top questions, compiled and answered by Practice Support. Questions include “What started the legal action that led to this settlement?” and “Are there any benefits beyond the $65 million payment?”

A San Francisco Superior Court judge has granted final approval of the $65 million amended settlement agreement between Delta Dental of California and the plaintiff class of Premier dentists. The comprehensive settlement is the result of a lengthy legal battle that CDA initiated in 2013 after learning of Delta Dental’s plans to reduce Premier provider rates by 8 to 12 percent. CDA brought the litigation in order to protect the rights of its members and to require Delta Dental to honor the terms of its contracts.

Dentists seeking information regarding CDA’s amended settlement agreement with Delta Dental can find all related information posted at DeltaDentalofCaliforniaSettlement.com. Under the settlement agreement, Delta Dental must pay $65 million to Premier Providers whose rates were impacted by an inflationary guard. Not every Premier Provider had his or her fees reduced by this procedure, but those who did will receive some proportionate reimbursement.

In a hearing on Dec. 27, a San Francisco Superior Court judge granted preliminary approval of the amended settlement agreement
between Delta Dental of California and the plaintiff class of Premier dentists. After an error in the financial calculations was discovered during the validation CDA required of the prior settlement amounts, the new settlement includes an agreement by Delta Dental to pay an unprecedented monetary award of more than $65 million and expands the number of dentists eligible for awards to more than 14,000.

A revised proposed settlement agreement between Delta Dental of California and the plaintiff class of Premier dentists has been filed in Superior Court. The revised settlement includes an agreement by Delta Dental to pay an unprecedented monetary award that nearly doubles the amount the parties had previously agreed upon to more than $65 million.

A case management conference related to CDA's proposed settlement agreement with Delta Dental has been rescheduled for Oct. 11, from the previous date of Aug. 25. The hearing was scheduled to provide additional time for CDA, Delta Dental and the court to review procedures that were used to estimate the impact of the inflation adjustment percentage.

A San Francisco Superior Court judge has delayed dates related to CDA’s proposed settlement agreement with Delta Dental — the June 26 deadline to opt out or object to the proposed settlement and the Aug. 31 hearing on final approval. The action will provide additional time for CDA, Delta Dental and the court to review procedures that were used to estimate the impact of the inflation adjustment percentage (INAP). Delta Dental’s INAP is the basis for the alleged underpayment to class members.

Dentists who are part of a class action lawsuit against Delta Dental of California should have received by mail a notice of the proposed settlement. Preliminary approval of the proposed settlement by a San Francisco Superior Court judge on April 21 triggered a settlement administrator to issue formal notices to dentists who are part of the class. The notices were mailed on May 11.

A San Francisco Superior Court judge has granted preliminary approval of a proposed settlement between CDA and Delta Dental of California. The preliminary approval triggers a settlement administrator to issue formal notices to the class of dentists who are affected by the proposed settlement. Dentists should expect to receive their formal notices in the mail in mid-to-late May.

After a long legal battle against Delta Dental, CDA achieved a favorable outcome on behalf of dentists regarding Delta's attempt to reduce Premier Provider reimbursement rates. In a letter to members, CDA President Clelan Ehrler, DDS, MS, outlines the successful outcome and provides a summary of settlement details.

Recent contractual amendments made by Delta Dental of Michigan, Ohio and Indiana effective Jan. 1, 2017, state that dentists who chose to opt out of Medicare Part D in these three states will no longer be eligible to remain Delta Dental network providers. Delta Dental of California verified that it is not adopting the same policy.

I am writing to share positive news about CDA's legal action against Delta Dental. A superior court judge has issued a preliminary ruling in favor of CDA regarding our association's standing to represent members in the case.

CDA is scheduled to present further evidence in its legal case against Delta Dental at a hearing scheduled Nov. 16 in San Francisco Superior Court. This is a further hearing on CDA’s “standing” as an association to represent its members in challenging Delta’s actions relating to reduced fee reimbursements to Premier dentists under the Delta Participating Dentist Agreement (“PDA”). While arguments on CDA’s legal standing to represent members in the case were presented earlier this year, the judge had remaining questions and allowed both parties to gather evidence to present at the upcoming hearing.

The San Francisco Superior Court judge presiding over the CDA v. Delta Dental case issued her final ruling denying Delta Dental’s motions attempting to have the case dismissed. The final ruling confirmed a tentative ruling of the same nature just weeks prior.

The San Francisco Superior Court judge presiding over the CDA v. Delta Dental case issued her tentative ruling at a March 18 hearing denying Delta Dental's motions attempting to have the case dismissed. While her rulings in open court are currently tentative, the judge stated that she would issue a final order soon and it would be consistent with these tentative rulings. This is positive news for CDA and CDA member Premier dentists, however, there is still a long way to go in the litigation.

In a Superior Court hearing scheduled for late March in San Francisco, CDA will counter motions made by Delta Dental regarding CDA’s legal action filed last year. During the hearing, which was postponed from January, a judge is expected to hear arguments on two Delta motions — one to dismiss the case and the other challenging CDA’s standing as an association to represent the interests of its members in court.

In an effort to keep members informed about the legal action against Delta Dental, CDA is providing an update on the next steps. Hearings have been scheduled in the coming months related to the case pending before arbitrators and a separate action filed in Superior Court. In the arbitration, a hearing has been scheduled for next June, after an arbitration panel denied a motion by Delta to dismiss the case. A panel of three arbitrators found that there is sufficient evidence to allow the individual dentists to proceed with claims that Delta’s attempt to change key provisions of its participating dentist agreements violated the legal doctrine of “good faith and fair dealing.”

A legal action was filed in August 2013 by CDA and several individual dentists challenging, in part, Delta’s attempt to change Premier provider agreements. Prior to the filing, CDA learned informally of a planned rate reduction of 8 to 12 percent. A recent decision by arbitrators will allow the arbitration to proceed despite a motion by Delta to dismiss it.

In August 2013, CDA and several individual dentists filed a legal action against Delta Dental challenging, in part, its attempt to change Premier provider agreements. In response to this action, Delta filed a motion to dismiss the entire matter. After considering the motion, the arbitrators rejected Delta Dental's recent motion to dismiss the entire action, and found that there was sufficient evidence to allow the individual dentists to proceed on their claims that Delta's attempt to change key provisions of its participating dentist agreements violated the legal doctrine of "good faith and fair dealing." The decision will allow the arbitration to proceed.

CDA learned in late May that Delta Dental of California began distributing a new Participating Provider Agreement (Commercial Fee-for-Service) to newly contracting California providers. For those newly contracting providers, this new agreement appears to be an all-inclusive provider agreement for both the Delta Dental Premier and PPO products. CDA understands that Delta Dental will no longer offer separate Premier and PPO provider agreements to newly contracting dentists. Along with the new Provider Agreement, newly contracting dentists will receive the Delta Dental Premier Addendum.

CDA received a ruling on April 10 from the arbitrators hearing the case against Delta Dental, who decided that CDA cannot participate as a claimant in the arbitration because CDA itself is not a party to the Premier provider agreement that contains the arbitration clause. However, CDA can still offer legal representation to all dentists who are parties to the binding arbitration and will continue to work with and support them throughout the proceedings.

CDA’s arbitration with Delta took a step forward on Feb. 25 with a “preliminary hearing” conference call with the panel of arbitrators assigned to the case. The purpose of the call was to schedule dates for different stages of the arbitration. In light of the extensive briefing that has already been submitted by both parties, the panel of three arbitrators has indicated it will likely decide two significant issues by early April.

CDA’s legal action against Delta took a step forward with a decision by the American Arbitration Association to select three arbitrators to hear and decide the case. The selection of an arbitration panel meant the case was able to move forward with a preliminary conference scheduled Feb. 25.

CDA’s legal action against Delta remains in the preliminary stages, with the parties awaiting appointment of an arbitrator. Delta has requested appointment of a three-arbitrator panel, which delayed the appointment process while the parties attempted to resolve the issue.

On Oct. 1, Delta Dental of California issued a formal Answer to the Demand for Arbitration. Delta asserts that it has the right to amend Participating Dentist Agreements based on language in the contracts and its notification to the Department of Managed Health Care indicating that it intends to revise the provider agreements.

The lengthy arbitration process between CDA and Delta Dental has commenced, with the parties entering into discussions about the selection of an arbitrator. Delta is expected to file a formal response to the demand for arbitration on or before Oct. 1.

CDA’s legal action challenges both Delta’s right to make certain amendments to dentists’ individual contracts and reduce Premier fees unilaterally. CDA will request that the arbitrator, once appointed, maintain the status quo until a final ruling is made in the binding arbitration.

CDA’s legal action against Delta Dental of California, filed on Aug. 14, has prompted member questions about the next steps in the process. In order to help members understand the legal action, CDA has prepared a FAQ document. CDA will continue to provide regular updates on developments in the case.

On behalf of its members, the California Dental Association — along with several individual dentist providers — has taken legal action against Delta Dental of California by filing a demand for binding arbitration in response to Delta’s notice dated Aug. 1, informing providers of changes to key provisions in their agreements.

While California providers are still waiting to hear from Delta Dental of California about expected fee reductions for its Premier Plan, Missouri dentists received a letter recently from Delta Dental of Missouri that outlined plans in that state to reduce reimbursements to providers who participate in Delta’s Premier and PPO networks. The fee reduction, which went into effect July 1, averages 7 percent. Delta Dental of California has not been forthcoming with its reasons for cutting reimbursement rates, nor has it officially informed California providers about its intentions; however, the reductions are expected to be an average of 8 to 12 percent implemented later this year.

CDA continues to advocate on behalf of its’ members concerning Delta Dental’s intention to cut Premier Plan provider reimbursement rates an expected average of 8 to 12 percent later this year. The following letter from CDA President Lindsey Robinson, DDS, explains to members that Delta has a responsibility and an obligation to communicate with its providers when inquiries are made, not limited to the legally required 45-day contract policy notice period, and failure to do so can result in providers filing complaints. The letter is as follows:

Since learning of Delta Dental’s decision to cut fees an expected average of 8 to 12 percent for its Premier product, CDA has pressed Delta for more specific details about the impending fee reduction. We have compiled a list to inform members about what we currently know. CDA will continue to provide information as soon as possible to keep members informed.

In a letter from CDA President Lindsey Robinson, DDS, the association is urging Delta Dental to communicate answers to providers about its impending rate reduction. Dr. Robinson’s message to members and the letter to Delta are posted here.

The March 2013 issue of the CDA Update features ways CDA Presents is valuable for new dentists. Specifically, six courses that new dentists will benefit from are highlighted. Spotlighting the key role that sterilization volunteers play at CDA Cares clinics, Diane E. Morgan-Arns, who served as the lead for sterilization at the CDA Cares Modesto and Sacramento clinics, and Eve Cuny, director of Environmental Health and Safety at the UOP, Arthur A. Dugoni School of Dentistry are interviewed.

CDA has learned that Delta Dental is planning to reduce reimbursement to its Premier Providers. We are now in contact with Delta to obtain details and clarification about this decision. It is likely these reductions will average 8 to 12 percent and may vary by region and provider. The reason for the reductions is not yet clear, but it is likely to be market pressures and a resultant effort to reduce the cost of the Premier plan for employers in order to keep it viable. The reductions will not go into effect immediately, but are intended to be implemented later this year.